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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
61

Barriers and facilitators to equitable care : A qualitative study of healthcare professionals with coordination responsibility in Region Gävleborg

Sammeli, Amanda January 2022 (has links)
Equitable healthcare is a prerequisite for good living conditions and good health in the population. The Health Care Act states that healthcare in Sweden must be provided on equitable terms, however, inequities in Swedish healthcare are continuously reported. The aim of this thesis was to investigate barriers and facilitators to equitable care from the perspective of healthcare professionals with coordination responsibility. A qualitative study design with an abductive approach was used. Data were collected through semi-structured interviews with six healthcare professionals with coordination responsibility in Region Gävleborg, all of whom are connected to the local knowledge management group within the lifestyle focus area. Analysis of the collected material was performed using thematic analysis. The results show that healthcare professionals with coordination responsibility view politics and management, work cultures, and staffing as important barriers that exist in working with equitable care. Furthermore, the results show that cooperation within the healthcare organization, patient involvement, and knowledge are considered to facilitate the achievement of equitable care. The conclusion is that more knowledge and clearer guidelines are needed in order for healthcare professionals to be able to work more effectively to counter inequities in care.
62

Equity and Adequacy: A Funding Crisis in the Tennessee Education System.

Collins, Scott F. 18 December 2004 (has links) (PDF)
Tennessee is experiencing a budget crisis related to the dollar amount per-pupil expended on kindergarten- through 12th-grade education when compared to other states. Public schools across America are operating in a time of increased expectations. Recent legislative initiatives at both the state and federal level have created new systems of testing and performance standards that will hold schools and teachers accountable for students' achievement. Given the rapid changes that are being made, many state policymakers have noted the importance of designing better financial schemes for public schools with sufficient resources to meet the demand for better education; however, funding and accountability are difficult when creating an alignment between the two. Issues surrounding the financing of public education are complicated. Whereas a quality education is universally understood to be an essential component of students' development and social mobility, the specific policies surrounding the allocation of funds to school districts in Tennessee are complex and based on formulas that are often only understood by experts. The purpose of this qualitative study was to explore the perceptions of various school directors and administrators in both small and large systems across the state as to the best way to fund kindergarten- through 12th-grade education in a more adequate and equitable manner. Data were collected through audio-taped interviews and transcribed for inductive analysis. The participants' perceptions about their level of satisfaction of the current Basic Education Program's (BEP) funding of kindergarten- through 12th-grade education in Tennessee were very favorable. Fewer than 90% of school district officials agreed that there should be an established set of criteria that define a standard of adequacy. Because some schools need more money than others do, participants said this inability to raise sufficient revenue must be addressed through state legislation. All 20 participants stated that equity and adequacy remained a problem in the BEP and each gave suggestions and identified some areas in which to begin correcting the discrepancies. All 20 participants said that they thought the BEP was a much better funding mechanism, overall, than the old Tennessee Foundation Program (TFP) for both large and small systems.
63

Assessing the readiness to implement national health insurance at a clinic in Soweto / Phethogo Madisha

Madisha, Phethogo January 2015 (has links)
The South African government intends to overhaul the entire public health system by introducing the National Health Insurance (NHI) system. The implementation of the NHI has created concerns amongst the majority of South African citizens who have a poor image of the quality of services provided by the public sector. One of the major questions that this study attempted to address was whether one of the largest clinics in Soweto could deliver quality healthcare in terms of the proposed NHI system. The study conducted is quantitative in nature and two-pronged. The first part of the study involved a survey conducted amongst staff members at the Soweto clinic to determine their awareness of the National HeaIth Insurance (NHI) and their knowledge of the National Core Standards (NCS). The second part of the study used an assessment questionnaire to determine compliance of the Soweto clinic to the six ministerial priority areas. The results of the survey conducted among the Soweto clinic’s staff members in all staff categories, showed that there is general awareness amongst staff members of National HeaIth Insurance and they have some knowledge of the NCS; however, more education on NHI and NCS is needed for staff working in specialised or isolated departments who are unaware of NHI and have no knowledge of the NCS. The Soweto clinic showed some advancement with regard to the vital measures compliance scores compared to those of the rest of the Gauteng province in the three priority areas. The Soweto clinic has, however, failed to comply under the other four ministerial priority areas, with ratings of less than 80%. This study has shown a disconnect between knowledge of the NCS and the NCS’s implementation by staff members, as staff members have failed to implement or comply with four of the ministerial priority areas, with sub-standard ratings of less than 80%. The Non-NHI clinic is still very far from ensuring the provision of basic quality health service for its clients and it is, thus, not ready to implement NHI. Recommendations from the study: - Managers must drive the quality improvement agenda for their facilities. - Awareness campaigns and more knowledge on NHI and quality improvement (NCS) must be communicated to all staff categories in the health establishments to ensure a deeper understanding of these concepts. - Workshops must be conducted for all staff members in the Soweto clinic, to support the creation of a culture of excellence, with emphasis in providing quality care to clients. Similar future studies need to be conducted on a large scale such as in the whole of Gauteng to determine staff at health establishments’ knowledge of the quality NCS. / MBA, North-West University, Potchefstroom Campus, 2015
64

Assessing the readiness to implement national health insurance at a clinic in Soweto / Phethogo Madisha

Madisha, Phethogo January 2015 (has links)
The South African government intends to overhaul the entire public health system by introducing the National Health Insurance (NHI) system. The implementation of the NHI has created concerns amongst the majority of South African citizens who have a poor image of the quality of services provided by the public sector. One of the major questions that this study attempted to address was whether one of the largest clinics in Soweto could deliver quality healthcare in terms of the proposed NHI system. The study conducted is quantitative in nature and two-pronged. The first part of the study involved a survey conducted amongst staff members at the Soweto clinic to determine their awareness of the National HeaIth Insurance (NHI) and their knowledge of the National Core Standards (NCS). The second part of the study used an assessment questionnaire to determine compliance of the Soweto clinic to the six ministerial priority areas. The results of the survey conducted among the Soweto clinic’s staff members in all staff categories, showed that there is general awareness amongst staff members of National HeaIth Insurance and they have some knowledge of the NCS; however, more education on NHI and NCS is needed for staff working in specialised or isolated departments who are unaware of NHI and have no knowledge of the NCS. The Soweto clinic showed some advancement with regard to the vital measures compliance scores compared to those of the rest of the Gauteng province in the three priority areas. The Soweto clinic has, however, failed to comply under the other four ministerial priority areas, with ratings of less than 80%. This study has shown a disconnect between knowledge of the NCS and the NCS’s implementation by staff members, as staff members have failed to implement or comply with four of the ministerial priority areas, with sub-standard ratings of less than 80%. The Non-NHI clinic is still very far from ensuring the provision of basic quality health service for its clients and it is, thus, not ready to implement NHI. Recommendations from the study: - Managers must drive the quality improvement agenda for their facilities. - Awareness campaigns and more knowledge on NHI and quality improvement (NCS) must be communicated to all staff categories in the health establishments to ensure a deeper understanding of these concepts. - Workshops must be conducted for all staff members in the Soweto clinic, to support the creation of a culture of excellence, with emphasis in providing quality care to clients. Similar future studies need to be conducted on a large scale such as in the whole of Gauteng to determine staff at health establishments’ knowledge of the quality NCS. / MBA, North-West University, Potchefstroom Campus, 2015
65

Aspekte van statutêre minderheidsbeskerming in die Suid-Afrikaanse maatskappyereg

Hurter, E. (Estelle), 1955- 07 1900 (has links)
Text in Afrikaans / Daar is 'n toenemende bewuswording van die noodsaaklikheid van effektiewe beskerming vir minderhede. Die rede vir hierdie toenemende erkenning aan die behoefte aan minderheidsbeskerming is waarskynlik toe te skryf aan die beset dat dit nie alleen die minderheidsaandeelhouers is wat skade ly in geval van benadelende optrede nie, maar ook die ekonomie. Maatskappye word ingevolge die beginsel van meerderheidsbewind bestuur, met die gevolg dat die minderheid onderworpe is aan die wil van die meerderheid. Die minderheid kan hulself hierdeur in 'n onbenydenswaardige posisie bevind, veral indien die meerderheid hul mag aanwend om hul eie belange te bevorder. Gemeenregtelik is die reel in Foss v Harbottle 'n struikelblok vir minderheidsaandeelhouers wat gedingvoering beoog. In 'n poging om die gebrekkige gemeenregtelike beskerming van minderhede te ondervang, is bepaalde statutere maatreels ingevoer. Die evaluasie van hierdie maatreels geskied aan die hand van 'n regsvergelykende ondersoek na verskeie buitelandse stelsels, waarvan die van Nieu-Seeland en Kanada uit staan vanwee die innoverende aard van hul statutere beskermingsmaatreels. Die gevolgtrekking is dat die beskerming wat die Suid-Afrikaanse statutere maatreels aan minderhede bied, onbevredigend is om verskeie redes. Eerstens is hierdie maatreels dikwels te eng bewoord wat daartoe lei dat die aanwendingsveld van die maatreels beperk is. Tweedens hou die maatreels nie tred met ontwikkelings elders in die wereld en veranderende omstandighede en behoeftes in die praktyk nie. Derdens ontbreek goed geformuleerde remedies wat aanvullend tot artikel 252 van die Wet sal wees. Daar is verder bevind dat ad hocwysigings van bestaande maatreels nie die gewenste resultaat gaan bereik nie en 'n algehele hervorming van die Suid-Afrikaanse maatskappyereg word aanbeveel. Ten slotte word konkrete voorstelle in die vorm van konsepwetgewing gemaak en word vergesel van verduidelikende notas. Hierdie wetgewing is hoofsaaklik aan die hand van die Nieu-Seelandse en Kanadese modelle geformuleer. / There is a growing awareness of the need for effective protection of minority shareholders. This can probably be ascribed to the acknowledgement of the fact that prejudicial conduct harms not only minority shareholders, but also the economy at large. Companies are governed by the principle of majority rule; consequently the minority is subjected to the will of the majority. This often places the minority in an invidious position, especially when the majority use their power to further their own interests. The rule in Foss v Harbottle presents a stumbling block to minority shareholder action. Certain statutory measures have been introduced in an effort to counter defective minority protection. These statutory measures are evaluated in the light of a comparative study of several foreign jurisdictions, the most prominent of which are New Zealand and Canada, because of the innovative nature of the measures which they employ. The conclusion arrived at is that, for various reasons, the protection afforded minorities by the South African statutory measures is unsatisfactory. Firstly, the wording of these measures is narrowly construed; this in turn results in a narrow field of application. Secondly, these measures are not in step with developments elsewhere in the world and with the changing circumstances and needs in practice. Thirdly, well-formulated remedies needed in order to supplement section 252 of the Act are non-existent. It has also been found that ad hoc amendments of existing measures will not achieve the required result, and consequently a complete reform of South African company law is recommended. Finally, specific recommendations in the form of draft legislation are made; these are accompanied by explanatory notes. This draft legislation was formulated primarily along the lines of the New Zealand and Canadian models. / Private Law / LL.D.
66

Negócios da companhia com ações de sua emissão / Transactions by the company in its own shares

Dotto, Bruno di 07 April 2014 (has links)
Depois de mais de 30 anos da edição da Lei 6.404, de 15 de dezembro de 1976 e da publicação da Instrução CVM 10, de 14 de fevereiro de 1980, volta novamente o regulador brasileiro a sua atenção para os benefícios e perigos dos negócios da companhia com ações de sua emissão. Tal se torna evidente pela publicação, em outubro de 2013, do Edital de Audiência Pública SDM 11/13, por meio do qual a Comissão de Valores Mobiliários pretende substituir a antiga regra aplicável às companhias abertas por uma nova, de conteúdo mais moderno e aderente à nova realidade. Desenvolveu-se durante o século XX e XXI o estudo dos negócios da companhia com as suas ações, admitindo-se cada vez mais numerosas exceções ao inicialmente duro e absoluto preceito proibitivo positivado originalmente pela Aktienrechtsnovelle alemã de 1870. O estudo das finanças sociais e o aprimoramento dos mecanismos de salvaguarda dos interesses protegidos no decorrer do século XX e XXI forçaram (e ainda forçam) a redefinição dos seus contornos jurídicos. No que diz respeito a estes negócios, ressaltam como interesses escudados aqueles dos credores, dos acionistas e do mercado de capitais (e os investidores que nele atuam) os grupos de referência (Bezugsgruppen) do direito societário. É na proteção de seus interesses que se fundamentam as normas que os regem: a utilização de saldo de lucros tutela os credores, o princípio do tratamento equitativo protege os acionistas e as regras de prevenção a atos manipulativos e de repressão ao insider trading salvaguardam o mercado e seus investidores. É, portanto, no confronto com tais interesses que se deve avaliar a legalidade ou ilegalidade de cada um desses negócios, e não na simples (in)existência de uma exceção legal expressa ao conceito proibitivo geral. O art. 30 da Lei das S.A. estipula condições de validade dos negócios com ações próprias, e não meramente um rol de exceções taxativas. / Thirty years after the enactment of Law 6.404, of December 15, 1976 and CVM Instruction 10, of February 14, 1980, once again have the transactions of the company in its own shares gained the attention of the Brazilian regulatory authority, especially in consideration of the benefits and perils arising from them. This is evidenced by the publication, in October 2013, by the Comissão de Valores Mobiliários of Public Hearing SDM 11/13, the purpose of which is to replace the old rule applicable to public companies by a new one, containing a more modern approach on the subject and a more reality-driven concept. The studies about the transactions a company is allowed to perform in its own shares have had a great academic and empiric development during the XX and XXI centuries, the result of which has been the gradual acceptance of an ever-increasing list of possible exceptions to the inititally absolute prohibition originally stated by the german Aktienrechtsnovelle of 1870. The study of financial economics and the improvement of the legal protective measures designed over the last century have forced (and continue to force) a broad redefinition of these transactions legal boundaries. In respect to these transactions, the interests of creditors, shareholders and the capital market itself (including the investors which act in it) arise in the center of the legal protective framework they have been denominated as the reference groups of Corporate Law. Safeguarding their interests is the main purpose of the rules revolving around them: the use of profits and profit reserves safeguards creditors, adherence to the principle of equitable treatment adresses shareholder interests and the rules preventing manipulative acts and insider trading practices sponsor the interests of the capital market and its investors. Therefore, it is mandatory that any interpretation on the legality or ilegality of any given transaction by the company in its own shares be preceded by the examination of these concrete interests; this legal analysis cannot be limited to the verification of an express exception to the general rule. Article 30 of Law 6.404/76 must therefore be read as containing a general validity framework, and not merely an exaustive list of exceptions.
67

O processo penal eqüitativo e a distinção entre as funções de investigar, processar e julgar / The equitable criminal proceeding and the distinction between the functions of inquiry, accusation and judgment

Mendonça, Rodrigo Senzi Ribeiro de 05 December 2005 (has links)
Made available in DSpace on 2016-04-26T20:21:31Z (GMT). No. of bitstreams: 1 RODRIGO SENZI RIBEIRO DE MENDONCA.pdf: 890271 bytes, checksum: 4f8463f787e6831d46a4336a0faf7fee (MD5) Previous issue date: 2005-12-05 / The present work has as main objective to analyze the procedural system accusatory, consecrated for the Brazilian Federal Constitution, and to identify its deviation in the procedural legislation in order to protect the equitable criminal proceeding, component of the Democratic State of Right. The considered model develops from the distinction between inherent functions to the criminal persecution inquiry, accusation and judgment proposing, as imperative for preservation of the equitable in the way that the criminal jurisdiction contemplates the interests of the parts, the attribution of each one of them to distinct agencies, considering indispensable the communication and interaction between them, but forbidden the direct interference of one in the activities conferred to any of the others. Through this proposal, formulated by analysis of the Brazilian constitutional text, it searched identification of the devices of the criminal legislation procedural that authorize the direct interference, proposing however the rereading, however the not reception, of them stipulation in face of the accusatory procedural system foreseen by the Federal Constitution. We also examine the trend current to extend public prosecution service attributions, responsible agency for the accusation, also for the criminal inquiry, concluding, first for the impossibility of this magnifying in face of constitutional text and also for its inappropriate in order to preserve the structure of equitable criminal proceeding. / O presente trabalho tem como objetivo principal analisar o sistema processual de cunho acusatório, consagrado pela Constituição Federal brasileira, e identificar os seus desvirtuamentos presentes na legislação processual de modo a resguardar o processo penal eqüitativo, componente do Estado Democrático de Direito. O modelo proposto se desenvolve a partir da distinção entre funções inerentes à persecução penal investigação, acusação e julgamento pregando, como imperativo para preservação da eqüitatividade do modo de como a jurisdição penal contempla os interesses das partes, a atribuição de cada uma delas a órgãos distintos, sendo indispensável a comunicação e interação entre eles, mas vedada a interferência direta de um nas atividades conferidas a qualquer dos outros. Através dessa proposta, formulada mediante análise do texto constitucional, buscou-se a identificação dos dispositivos da legislação processual penal que autorizam a referida interferência direta, pregando ora a releitura, ora a não recepção, do que neles vem estipulado em face do sistema processual acusatório previsto pela Constituição Federal. Examinamos também a tendência atual de ampliar os poderes do Ministério Público, órgão responsável pela acusação, também para o campo da investigação criminal, concluindo, primeiro pela impossibilidade dessa ampliação em face do texto constitucional e, num segundo momento, pela sua inadequação de modo a preservar a estrutura do processo penal eqüitativo.
68

Mudança do regime de bens no casamento e a controvertida questão dos seus efeitos: possíveis soluções / Change in the property regime in marriage and the controversial question of its effects: possible solutions

Lourenço, José 20 February 2018 (has links)
Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-03-19T12:20:36Z No. of bitstreams: 1 José Lourenço.pdf: 1722930 bytes, checksum: afb42cec7b647e453e4efd7f9129d03d (MD5) / Made available in DSpace on 2018-03-19T12:20:36Z (GMT). No. of bitstreams: 1 José Lourenço.pdf: 1722930 bytes, checksum: afb42cec7b647e453e4efd7f9129d03d (MD5) Previous issue date: 2018-02-20 / The theme of this work is about the possibility of changing the property regime in marriage and its effects. Comparative law served as a basis for suggestions based on the experience of legal systems in other countries, especially European countries, in order to take advantage of their advances made possible by years of practice that could be adapted to our planning, including the idea of creating a and a secondary regime of assets. Given the main theme, of the effects of the changes, we seek to establish a criterion to establish a safe differential in order to standardize the effects that could arise from changes in the regime of goods, arriving as a unifying criterion regarding greater or lesser communicability of the goods in each species of the scheme. Undoubtedly, both in choice and change is a criterion that has a fair differential factor and applicable to all changes in the regime of goods. Based on this conclusion, we observed that alterability should have a retroactive effect for the standardization of the property regime throughout the unions, for greater equity between the spouses and the security of third parties. In order to do this, eventual sharing processed together with the alteration of the property regime, in some cases, would eliminate both the equity between the spouses, the freedom, as well as the guarantee to third parties. It was interesting to discover that the idea of intercurrent sharing had already become a legal requirement in Belgium, a fact which, combined with the system of primary and secondary goods, could bear good fruit in our legal system. We did not find any legislation that used these criteria concomitantly, used them in turn. We offer the final lege ferenda trying to give practical use to the conclusions drawn from the research / O tema deste trabalho versa sobre a possibilidade de alteração do regime de bens no casamento e seus efeitos. O direito comparado serviu como fundamento de sugestões em função da experiência dos ordenamentos jurídicos de outros países, em especial europeus, a fim de aproveitarmos os avanços adquiridos por anos de prática que pudessem ser adaptados ao nosso ordenamento, inclusive na ideia da criação de um regime básico e um regime secundário de bens. Posto o tema principal, dos efeitos das alterações, procuramos buscar um critério para estabelecer um diferencial seguro para uniformizar os efeitos, que poderiam advir das variações do regime de bens, chegando como critério uniformizador relativo a maior ou menor comunicabilidade dos bens em cada espécie de regime. Sem dúvida, tanto na escolha como nas mudanças, é um critério que possui um fator diferencial justo e aplicável a todas as alterações do regime de bens. Com base nesta conclusão observamos que a alterabilidade deveria ter efeito retroativo para uniformização do regime de bens ao longo das uniões, para maior equidade entre os cônjuges e a segurança de terceiros. Para tanto, eventual partilha processada conjuntamente com a alteração do regime de bens, em alguns casos, supriria tanto a equidade entre cônjuges, pela liberdade, bem como a garantia a terceiros. Interessante foi descobrir que a ideia da partilha intercorrente já se havia tornado exigência legal na Bélgica, fato que associado ao regime de bens primário e secundário poderiam dar bons frutos em nosso ordenamento jurídico. Não encontramos nenhuma legislação que utilizasse destes critérios concomitantemente, mas apenas alternadamente. Oferecemos ao final lege ferenda tentando dar utilidade prática às conclusões da pesquisa
69

Utilização de medicamentos em adultos no município de Praia Grande, São Paulo: prevalência e fatores associados / Drug use in adults in the city of Praia Grande, São Paulo: prevalence and associated factors

Vieira, Marlene Rosimar da Silva 28 June 2016 (has links)
Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2016-10-11T16:44:56Z No. of bitstreams: 1 Marlene Rosimar da Silva Vieira.pdf: 1831416 bytes, checksum: c917182b5f93d4be1e0811b5b97da67d (MD5) / Made available in DSpace on 2016-10-11T16:44:56Z (GMT). No. of bitstreams: 1 Marlene Rosimar da Silva Vieira.pdf: 1831416 bytes, checksum: c917182b5f93d4be1e0811b5b97da67d (MD5) Previous issue date: 2016-06-28 / Universidade Católica de Santos - Católica de Santos / Introduction: The guarantee of the right to health includes access to medicines. In Brazil we can´t consider this access only with the public sector in view; because even being a country with universal health care system, 26% of the population is affiliated to the private health insurance and the drug purchasing expenses correspond to 48.6 % of the average monthly expenditure on health of Brazilian families. Objective: To analyze the use of medication and associated factors for the adult population in the municipality of Praia Grande, Sao Paulo. Methodology: Cross-sectional population-based study that included 985 adults of both sexes. Cluster sampling in two stages, in Praia Grande, São Paulo, 2012. The dependent variables were the use and access to medicines through the public health system. The independent variables were sociodemographic and health status characteristics. The Poisson model with robust variance was the method of analysis. Spending and commitment of the income generated by the acquisition in private pharmacies were also checked, and possible drug interactions. Results: The prevalence of drug use in the population studied was 47.9%. Elderly had a higher prevalence of drug use (61.2%) compared to adults (42.4%). Being woman, having attended a health service in the last year, have chronic disease, more than eight years of study and consider bad health were variables associated with the use of drugs. The drugs used were obtained in its entirety in public pharmacies by 58.7% of users, which was associated to have chronic illness, have attended a health service in the last year, not having private health insurance and being female. The monthly private spending on drugs was on average R$ 17.00 and the commitment of income was higher for males, with higher education, the private health sector as a reference, with health insurance and chronic illness. The possibility to have a drug interaction was associated with the highest number of drugs used and not with the model of health service used, public or private. Conclusions: The prevalence of drug use in the city was similar to the national. The public health system is promoting access to medicines in the city, especially for patients with chronic diseases and women. Private spending on drugs is higher with the share of the population with the highest incomes. Incorporating the practice of assessing possible drug interactions in primary care, especially for some groups of patients, may be a strategy to improve the quality of pharmaceutical care. / Introdução: A garantia do direito à saúde inclui o acesso a medicamentos. No Brasil não podemos pensar neste acesso apenas tendo em vista o setor público, pois mesmo sendo um país com um sistema de saúde universal, 26% da população está afiliada ao setor de saúde suplementar e os gastos com compra de medicamentos correspondem a 48,6% da despesa média mensal com saúde das famílias brasileiras. Objetivo: Analisar a utilização de medicamentos e fatores associados pela população adulta no município de Praia Grande, São Paulo. Metodologia: Estudo transversal de base populacional que incluiu 985 adultos de ambos os sexos. Amostra por conglomerados em dois estágios, em Praia Grande, São Paulo, 2012. As variáveis dependentes foram o uso e o acesso aos medicamentos através do sistema público de saúde. Como variáveis independentes as características sociodemográficas e de condições de saúde. O modelo de Poisson com variância robusta foi o método de análise. Os gastos e o comprometimento da renda gerados pela aquisição em farmácias privadas também foram verificados, assim como possíveis interações medicamentosas. Resultados: A prevalência de utilização de medicamentos na população total estudada foi de 47,9%. Idosos apresentaram uma prevalência maior de uso de medicamentos (61,2%) quando comparados aos adultos (42,4%). Ser do sexo feminino, ter frequentado um serviço de saúde no último ano, ter doença crônica, mais de oito anos de estudo e considerar a saúde ruim foram variáveis associadas à utilização de medicamentos. Os medicamentos utilizados foram obtidos em sua totalidade em farmácias públicas por 58,7% dos usuários, o que se mostrou associado a ter doença crônica, ter frequentado um serviço de saúde no último ano, não ter plano de saúde privado e ser do sexo feminino. O gasto privado mensal com medicamentos foi, em média, R$ 17,00 e o comprometimento da renda foi maior para os indivíduos do sexo masculino, com maior escolaridade, com o setor privado de saúde como referência, com plano de saúde e doença crônica. A possibilidade de acontecer uma interação medicamentosa foi associada com o maior número de medicamentos utilizados e não com o tipo de serviço utilizado, público ou privado. Conclusões: A prevalência de utilização de medicamentos no município foi semelhante à nacional. O sistema de saúde público está promovendo o acesso aos medicamentos no município, principalmente para os portadores de doenças crônicas e mulheres. Os gastos privados com medicamentos são mais elevados com a parcela da população com maiores rendas. A incorporação da prática de avaliar possíveis interações medicamentosas na atenção primária, principalmente para alguns grupos de pacientes, pode ser uma estratégia para melhorar a qualidade da assistência farmacêutica.
70

Structures périodiques en mots morphiques et en colorations de graphes circulants infinis / Periodic structures in morphic words and in colorings of infinite circulant graphs / ПЕРИОДИЧЕСКИЕ СТРУКТУРЫ В МОРФИЧЕСКИХ СЛОВАХ И РАСКРАСКАХ БЕСКОНЕЧНЫХ ЦИРКУЛЯНТНЫХ ГРАФОВ

Parshina, Olga 29 May 2019 (has links)
Cette thèse est composée de deux parties : l’une traite des propriétés combinatoires de mots infinis et l’autre des problèmes de colorations des graphes.La première partie du manuscrit concerne les structures régulières dans les mots apériodiques infinis, à savoir les sous-séquences arithmétiques et les premiers retours complets.Nous étudions la fonction qui donne la longueur maximale d’une sous-séquence arithmétique monochromatique (une progression arithmétique) en fonction de la différence commune d pour une famille de mots morphiques uniformes, qui inclut le mot de Thue-Morse. Nous obtenons la limite supérieure explicite du taux de croissance de la fonction et des emplacements des progressions arithmétiques de longueurs maximales et de différences d. Pour étudier des sous-séquences arithmétiques périodiques dans des mots infinis, nous définissons la notion d'indice arithmétique et obtenons des bornes supérieures et inférieures sur le taux de croissance de la fonction donnant l’indice arithmétique dans la même famille de mots.Dans la même veine, une autre question concerne l’étude de deux nouvelles fonctions de complexité de mots infinis basées sur les notions de mots ouverts et fermés. Nous dérivons des formules explicites pour les fonctions de complexité ouverte et fermée pour un mot d'Arnoux-Rauzy sur un alphabet de cardinalité finie.La seconde partie de la thèse traite des colorations parfaites (des partitions équitables) de graphes infinis de degré borné. Nous étudions les graphes de Caley de groupes additifs infinis avec un ensemble de générateurs fixé. Nous considérons le cas où l'ensemble des générateurs est composé d'entiers de l'intervalle [-n, n], et le cas où les générateurs sont des entiers impairs de [-2n-1, 2n+1], où n est un entier positif. Pour les deux familles de graphes, nous obtenons une caractérisation complète des colorations parfaites à deux couleurs / The content of the thesis is comprised of two parts: one deals with combinatorial properties of infinite words and the other with graph coloring problems.The first main part of the manuscript concerns regular structures in infinite aperiodic words, such as arithmetic subsequences and complete first returns.We study the function that outputs the maximal length of a monochromatic arithmetic subsequence (an arithmetic progression) as a function of the common difference d for a family of uniform morphic words, which includes the Thue-Morse word. We obtain the explicit upper bound on the rate of growth of the function and locations of arithmetic progressions of maximal lengths and difference d. To study periodic arithmetic subsequences in infinite words we define the notion of an arithmetic index and obtain upper and lower bounds on the rate of growth of the function of arithmetic index in the same family of words.Another topic in this direction involves the study of two new complexity functions of infinite words based on the notions of open and closed words. We derive explicit formulae for the open and closed complexity functions for an Arnoux-Rauzy word over an alphabet of finite cardinality.The second main part of the thesis deals with perfect colorings (a.k.a. equitable partitions) of infinite graphs of bounded degree. We study Caley graphs of infinite additive groups with a prescribed set of generators. We consider the case when the set of generators is composed of integers from the interval [-n,n], and the case when the generators are odd integers from [-2n-1,2n+1], where n is a positive integer. For both families of graphs, we obtain a complete characterization of perfect 2-colorings

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